Thyrotoxic heart failure: A review of clinical status and meta-analysis of electrocardiogram diagnosis and medical clinical management methods

Heart failure (HF) is the final common pathway of many cardiovascular diseases (CVD). It imposes significant socio-economic and healthcare burden to both patients and healthcare systems. Although the most common cause of HF is ischemic heart diseases, other less common causes such as hyperthyroidism (thyrotoxicosis) should also be considered during diagnosis to improve overall clinical management of HF. Hyperthyroidism is a potentially reversible and curable cause of thyrotoxic HF (THF), which should be excluded in every new patient with HF especially in the absence of coronary artery disease and other structural heart diseases. However, the etiology of thyrotoxic HF remains partially understood – is it the consequence of hemodynamic insult, direct toxic effect or both? Its epidemiology is also difficult to assess because hypertensive, ischemic and other structural heart diseases have not been thoroughly excluded. The present review seeks to aggregate current published evidence on THF to provide a comprehensive understanding of its definition, prognosis, pathogenesis, manifestation, diagnosis and clinical management.